Diagnostic Testing

Diagnostic testing for thoracolumbar conditions is similar to that for the cervical spine. Plain radiographs (AP, lateral, and oblique views) can be obtained (Fig. 31-15). CT, MRI, or myelography may be indicated in patients with worsening neurologic deficits or a suspected systemic cause of back pain, such as infection or neoplasm. These imaging studies are also useful when referral for surgery is considered.

Table 31-2 Normal Range of Movement: Thoracolumbar Spine

Motion

Range

Flexion

0-80 degrees

Extension

0-20 degrees

Lateral bend

0-35 degrees

Rotation

0-45 degrees

Modified from Carr AJ, Harnden A. Orthopedics in Primary Care. Newton, Mass, Butterworth-Heinemann, 1997.

Figure 31-13 Bowstring sign. (From Reider B. The Orthopedic Physical Examination. Philadelphia, Saunders, 1999, p 365.)
Figure 31-14 Femoral nerve stretch test. (From Reider B. The Orthopedic Physical Examination. Philadelphia, Saunders, 1999, p 367.)
Dealing With Back Pain

Dealing With Back Pain

Deal With Your Pain, Lead A Wonderful Life An Live Like A 'Normal' Person. Before I really start telling you anything about me or finding out anything about you, I want you to know that I sympathize with you. Not only is it one of the most painful experiences to have backpain. Not only is it the number one excuse for employees not coming into work. But perhaps just as significantly, it is something that I suffered from for years.

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